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How to use a nasopharyngeal airway (NPA)


What is an NPA?

  • A flexible rubber tube which goes through the nose ends at base of tongue (an adjunct to help keep airway open)
    • An oxygen mask or bag mask ventilation can be applied over the top if needed
  • Use: prevents tongue covering epiglottis in patients with reduced GCS. It is tolerated better than oropharyngeal airways in more alert patients.
  • Size: Average height females require a size 6 NPA and average height males a size 7 NPA (Portex sizing)
    • Sizing using the patient’s finger as a guide is no longer recommended.


How to insert an NPA

  • Lubricate the nasopharyngeal airway with water-soluble jelly
  • Insert into the nostril (preferably right) vertically along the floor of the nose with a slight twisting action
    • Aim towards the back of the opposite eyeball
  • Confirm airway patency


Video on NPA insertion

Sizes of NPA

Nasopharyngeal airways
Nasopharyngeal airways (NPAs). The addition of safety-pins to the flanged end prevents them being lost into the oropharynx.


Other airway pages